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J Thorac Cardiovasc Surg 1998;116:454-458
© 1998 Mosby, Inc.

Surgery for Adult Cardiovascular Disease

Difference in acetylcholine-induced nitric oxide release of arterialand venous grafts in patients after coronary bypass operations

From the Department of Surgery III, Nara Medical University, Nara,Japan.

Received for publication June 24, 1997. Revisions requested Sept. 24, 1997; revisions received March 9, 1998. Accepted for publication March 9, 1998. Address for reprints: Hiroaki Nishioka, MD, Department of Surgery III,Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634, Japan.

Objectives: In vivo investigation ofnitric oxide release in coronary bypass grafts has not been reported. We studiedacetylcholine-induced nitric oxide release in vivo of coronary bypass grafts andvasomotor responses to acetylcholine of grafted coronary arteries in patientsafter coronary bypass grafting.
Methods:We examined 24 internal thoracic artery grafts and 16 saphenous vein grafts in39 patients. The mean ages of the patients were 65 years for the arterial graftsand 68 years for the venous grafts. Nitric oxide was measured as the plasmanitrite level by the Griess reaction. Before and after intragraft acetylcholineinfusion (5 µg), blood was sampled from the distal end of the graft, andangiograms were taken and analyzed by cine-densitometry.
Results: The plasma nitrite concentration afterstimulation with acetylcholine compared with the control value was 134%± 52% at 4 minutes (P = 0.05)and 184% ± 107% at 6 minutes (P =0.01) in the arterial grafts; in the venous grafts these values were 101%± 24% at 4 minutes (P  =0.96) and 108% ± 36% at 6 minutes (P =0.69). Low-dose acetylcholine dilated the coronary arteries supplied by arterialgrafts by 6.3% ± 16.6% whereas coronary arteries suppliedby venous grafts were reduced by 9.8% ± 11.8% in diameterand the vasoactive responses were different (P =0.01).
Conclusions: In vivo internalthoracic artery grafts had more endothelium-derived nitric oxide release inresponse to acetylcholine than did saphenous vein grafts after coronary bypassgrafting.

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